ArticleActa endocrinologica (Bucharest, Romania : 2005)
COULD THE RATE OF DECREASE IN INTRAOPERATIVE PARATHYROID HORMONE LEVEL BE A DETERMINANT OF SURGICAL TECHNIQUE IN TERTIARY HYPERPARATHYROIDISM?
Article in Acta endocrinologica (Bucharest, Romania : 2005). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Context: Intraoperative parathyroid hormone (IO PTH) monitoring has determinative role in surgery for tertiary hyperparathyroidism (tHPT). Objective: We tried to find out whether the extent of surgery to be performed can be dedicated via IO PTH monitoring in tHPT. Design: Renal transplantation (RTX) recipients who had been operated and followed up because of tHPT between 9/2014 and 5/2021 at our institution were retrospectively analysed. Subjects and Methods: We analysed the pre-operative and postoperative data of 41 patients with tHPT. Results: Considering IO PTH monitoring; 70% and more decrease of the hormone level leaded us favourable results (89% surgical success) regardless of the PTX method (p<0.05). We obtained the same surgical success rate (75%) in patients in whom monitoring was done and was not done. We observed high success ratios (100%) in the latter group via subtotal PTX and total PTX plus autotransplantation (AT) (p<0.05). Conclusions: In surgery for tHPT, IO PTH monitoring should be maintained. When we observe 70% or more decline in the hormone level, we can decide to finish the operation regardless of the surgical technique. If hormone level decrease is below 70%, we have to continue exploration.
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